Hospitals In Northwest Research Articles

Disability scores rate changes and predictors among road traffic injury victims admitted at Gondar specialized comprehensive hospital northwest Ethiopia: A prospective follow-up study

Objective Measuring the level of disability following trauma is a key step for secondary and tertiary level trauma prevention. It can give important evidence for decision-makers and program implementers on the need for establishing rehabilitation centers. Methods This is a longitudinal follow-up study on 235 road traffic injury survivors. Patients were followed for 12 months, and the outcome was ascertained using the brief WHODAS-II 12-item instrument at 1, 3, 6, and 12-months post-injury. The level of disability was divided into five groups from no disability to very severe based on their disability scores. Work status was assessed at each survey using a single question “are you back to work?” We employed a linear mixed model to identify disability scores changes over time and risk factors associated with disability. Statistically, a significant association was declared at p < 0.05. Results The overall mean disability score was 24.9 ± 11.3 at one month and 8.3 ± 6.4 after 12 months of injury. Disability score has decreased by 1.3 units over time during 12 months post-injury. Functional limitation persisted on 25–88% of participants at specific dimensions of disability at the end of the study. After a year of injury, 44% of participants didn’t return to work. Injury severity score (β = 0.47, p < 0.001, length of hospital stays (β = 0.88, p < 0.005) and discharge against medical advice (β = 2.18, p < 0.001) were found to be predictors of disability following road traffic injuries. Conclusion The current study demonstrated that, though there was a decrease in disability score over time, a significant number of participants were with some degree of limitation after one year of injury, and nearly half of them didn’t return to work. Shortening of long waiting times and counseling services need to be considered by the hospital. Community-based Rehabilitation centers (CBR) should be expanded. Further study should be conducted to uncover the reasons for preferring traditional bone fixers over medical management.

Clinical frailty as a key characteristic of the patient population of the NHS Nightingale North West COVID-19 temporary emergency field hospital: cohort study April to June 2020.

ObjectivesCOVID-19 temporary emergency ‘field’ hospitals have been established in the UK to support the surge capacity of the National Health Service while protecting the community from onward infection. We described the population of one such hospital and investigated the impact of frailty on clinical outcomes.DesignCohort study.SettingNHS Nightingale Hospital North West, April–June 2020.ParticipantsAll in-patients with COVID-19.Main Outcome MeasuresMortality and duration of admission.MethodsWe analysed factors associated with mortality using logistic regression and admission duration using Cox's regression, and described trends in frailty prevalence over time using linear regression.ResultsA total of 104 COVID-19 patients were admitted, 74% with moderate-to-severe frailty (clinical frailty score, CFS > 5). A total of 84 were discharged, 14 transferred to other hospitals, and six died on site. High C-reactive protein (CRP) > 50 mg/dL predicted 30-day mortality (adjusted odds ratio 11.9, 95%CI 3.2–51.5, p < 0.001). Patients with CFS > 5 had a 10-day median admission, versus 7-day for CFS ≤ 5 and half the likelihood of discharge on a given day (adjusted hazard ratio 0.51, 95%CI 0.29–0.92, p = 0.024). CRP > 50 mg/dL and hospital-associated COVID-19 also predicted admission duration. As more frail patients had a lower rate of discharge, prevalence of CFS > 5 increased from 64% initially to 90% in the final week (non-zero slope p < 0.001). Conclusions: The NNW population was characterized by high levels of frailty, which increased over the course of the hospital's operation, with subsequent operational implications. Identifying and responding to the needs of this population, and acknowledging the risks of this unusual clinical context, helped the hospital to keep patients safe.

Poster session

The Nightingale Hospital North West (NHNW) was a temporary field Hospital, built and run in collaboration between the NHS and the military. The Hospital was assembled in record time to combat the additional pressures placed on the NHS during the COVID-19 global pandemic. Due to the distance of the NHNW from Oxford Road Campus (ORC), the Transfusion service was asked to supply on-site O D Negative red cells for emergency blood provision on the 8th of April 2020. We needed a quick, creative and safe way to bring the blood closer to the patients. After seeing the already successful collaboration between the NHS and the military, it was decided what better way to support the war on COVID-19, but to respond as the military would. This solution came in the form of Golden HourTM Technology, Credo Cube;this technology was originally designed for the military to protect temperature sensitive components in the battlefield. Validation was carried out in a staggered approach to ensure a Credo Cube was on site as soon as possible. Each Credo Cube was validated for up to 120 hours. Variations on user preparation, packaging and stability meant we decided to adopt a 72 hour change over with the NHNW to fit in with our current workload. Continuous temperature monitoring was achieved by utilising small microchip temperature devices, to aid early detection of any problems and protect the quality of the emergency units issued. Each Credo Cube was truly-'Emergency Blood Provision in a Box'. The Cube contained giving sets and all documentation and information for the NHNW staff, including guidance on transfusion, traceability, transfer and investigation of transfusion reactions. The blood was on site by the 20th of April 2020, this was an extremely short time frame and a true collaboration between Wythenshawe Hospital and Oxford Road Campus. Our success was measured by the availability of emergency units to the NHNW patients, safeguarding against a Major Haemorrhage and supporting transfer of the critical patients back to A&E. This gave our users re-assurance that all patients within our care had the safest blood available for their needs.

Nurses Knowledge, Practice, and Associated Factors Toward Prevention of Surgical Site Infection in Benishangul Gumuz Hospitals Northwest Ethiopia 2021

Introduction: Surgical Site Infection (SSI) is one of the most common types of Healthcare associated infection which is considered to be 20% to 25% of all infections. It is an infection which occurs within 30 days after a surgical procedure or up to one year in those surgical patients in which an implant has been placed in an organ. SSI were the leading infections in developing country and strikingly higher proportions recorded in developed countries. Objective. nurses’ knowledge, practice, and associated factors towards surgical site infection prevention in Benishangul Gumuz Regional north West Ethiopia 2021. Methods: A facility based cross-sectional study was conducted among staff nurse in Benishangul Gumuz regional hospitals, western Ethiopia from janury 1st to October 1st 2021. A total of 218 nurses were recruited consecutively as study subjects. Data was collected using structured questionnaire. The collected data was analyzed using SPSS version 20.0 and descriptive statistic was used to indicate the frequency and percentage of variables and chi-square was used to determine the predictors of nurse’s knowledge and practice at P values <0.05 was considered determine significant association. Result: about two handed eighteen study subject were interviewed the finding shows that 51.8% of nurse were not knowledgeable and around 47.2% of nurses were having poor practice toward SSI prevention. Chi-square test shows that variables like marital status, working period and work experience has got association with nurses’ knowledge and practice toward SSI prevention. finally training standard SSI prevention guideline close monitoring is required from respective facility and stakeholders.

Magnitude of anemia and associated factors among children aged 6\u201359\u2009months at Debre Markos referral hospital, Northwest Ethiopia: a hospital-based cross-sectional study

BackgroundAnemia, the most common micro-nutrient deficiency disorder, is the world’s second leading cause of morbidity and morbidity, affecting 24.8% of the population, of which 47.4% are under-five children. The prevalence of anemia ranges from 44 to 56% in Ethiopia. Although its magnitude has shown decreases across regions; it continues to be a significant public health problem, particularly in developing countries including Ethiopia. Despite this evidence, the magnitude and associated factors of anemia was not systematically explored and there is a limited information or limited evidences in the study area. Hence, the aim of this study was to assess the magnitude and associated factors of anemia among children aged 6–59 months attending at Debre Markos Referral Hospital, Northwest Ethiopia.MethodsA hospital-based cross-sectional study was conducted at Debre Markos referral hospital Northwest Ethiopia from September 30 to December 30, 2019. Data on socio-demographic and socio-economic factors, health and nutritional features of children and their mothers were obtained using pre-tested structured questionnaires in a face-to-face interview with child care providers. Blood samples and stool examination for intestinal parasites were performed. Hemoglobin level was analyzed using the HemoCue device (HemoCueHb 301). The collected data were coded, cleared and entered into Epi-Data version 3.1, and analyzed using Stata version 14 software. To identify candidates and predictor variables, bivariate and multivariate logistic regressions were applied respectively. The significance level was determined at a confidence interval of 95% at p-value < 0.05.ResultsOf the total of 341 participants planned to be participated, about 310 mother-child pairs participated in the study, giving a response rate of 91%; and data were collected from children as well as their parents or guardians.In this study, the magnitude of anemia was 11.9% (95% CI, 8.5, 16.2%). Poor dietary diversity (AOR = 2.3; 95% CI: 1.12, 5.14), food-insecure households (AOR = 3.24; 95% CI: 1.85, 4.52), complementary feeding initiation time (AOR = 3.20; 95% CI:1.23, 6.61), intestinal parasites infection (AOR = 3.20; 95% CI:1.23, 6.61) and family income (AOR = 2.87; 95% CI:1.57, 5.0) were found to be factors significantly associated with anemia.ConclusionOverall, anemia is considered a public health problem among children aged 6–59 months attending at Debre Markos referral hospital, based on the cut-off point of the World Health Organization. Poor dietary diversity, complementary feeding initiation time, household food insecurity, intestinal parasite infection and family income were significantly associated with childhood anemia. Thus, it needs for proven interventions in public health such as food diversification, anti-helmintic drug provision and household food security. In addition, educating women about nutrition and diet diversification, as well as involving them in alternative sources of income-generating activity, can be vital in the study area.

Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia

BackgroundAs the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education’s effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia.MethodsTo address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale.ResultsSelf-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (β = 4.15, p < 0.05) and increased with each round of education. Other factors significantly associated with adherence scores were being single (β = − 0.25, p < 0.05), taking aspirin (β = 0.76, p < 0.05), and having a history of hospitalization (β = 0.91, p < 0.05).ConclusionsWe find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management.Trial registration number: PACTR201908812642231

Health-Related Quality of Life Among Heart Failure Patients Attending an Outpatient Clinic in the University of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia, 2020: Using Structural Equation Modeling Approach.

BackgroundChronic heart failure is one of the most important public health concerns in the industrialized and developing world having increasing prevalence. Measuring quality of life using rigorous statistical methods may be helpful to provide input for decision-makers and the development of guidelines. This study aimed to assess health-related quality of life and associated factors among heart failure patients attending the University of Gondar Specialized Hospital.MethodsA cross-sectional study was employed to select 469 heart failure patients who have follow-up at the University of Gondar Specialized Hospital consecutively from March 01 to 30, 2020. Data were entered to Epi Info 7 and exported to STATA version 15 for further statistical analysis. The quality-of-life domains were measured with World Health Organization Quality of Life BREF. Structural equation modeling was employed to estimate the relationships among exogenous, mediating, and endogenous variables simultaneously.ResultsChronic heart failure patients had a significantly lower mean score in physical health domain (31.70 mean score), environmental health domain (38.35 mean score), and in overall quality of life domain (41.61 mean score) moderate in social relation domain (46.22 mean score), and in psychological health domain (50.21 mean score) of health-related quality of life (p-value <0.0001). Age had a direct positive effect on health-related quality of life. Residency also had a direct negative effect on both physical and environmental health-related quality of life domain. Duration of heart failure had a direct negative effect on psychological health.ConclusionThe finding of this study indicated that poor health-related quality of life in the physical health domain, moderately poor in overall health-related quality of life, and moderate health-related quality of life in the psychological health domain among Chronic heart failure patients. Age, residence, marital status, income, and duration of HF were significantly associated factors for quality of life among HF patients.

Prevalence and Associated Factors of Depression among Pregnant Mothers Who Had Intimate Partner Violence during Pregnancy Attending Antenatal Care at Gondar University Hospital Northwest Ethiopia in 2020.

Background Antenatal depression is the major obstetric problem that led to significant maternal and perinatal morbidity and mortality worldwide, especially in the third world. However, in Ethiopia this prevalence and association were not studied, as result, this study investigated the prevalence and associated factors of antenatal depression among pregnant mothers who had intimate partner violence during pregnancy. Methodology. An institution-based cross-sectional study was done among 409 pregnant mothers who had intimate partner violence during pregnancy from May to July 2019 at Gondar University Hospital. All pregnant mothers who came for ANC follow-up during the study period approached for screening of intimate partner violence during pregnancy using standard and validated screening method and instrument of the WHO multicountry study on women's health and domestic violence to evaluate intimate partner violence, and we use EPDS for the evaluation of antenatal depression validated in Ethiopia with a cut point of 13. Result Prevalence of depression among pregnant mothers who had any form of intimate partner violence during pregnancy was 35%: physical abuse (AOR = 1.8; 95% CI: 1.19, 3.30), more than one type of abuse (AOR = 10.18; 95% CI: 7.10, 16.18), poor social support (AOR = 5.81; 95% CI: 1.12, 13.12), and pregnant mothers whose partner drunk for the past twelve months (AOR = 7.16; 95% CI: 183, 8.00) were significantly associated with antenatal depression. Conclusion High prevalence of antenatal depression among pregnant mothers who had intimate partner violence during pregnancy was highly associated with physical abuse, more than one type of abuse, lack of social support, and partner of pregnant mothers who is a drunk. Hence, this is important to create a screening program and prevention strategy of intimate partner violence during pregnancy at the time of antenatal follow-up to prevent and early identify its morbidity and mortality.

Prevalence and associated factors of hemorrhoids among adult patients visiting the surgical outpatient department in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

IntroductionHemorrhoidal disease is a very common benign anorectal disease. It affects millions of people around the world, and represent a major medical and socioeconomic problem. However, studies that determine the magnitude and risk factors are limited. Therefore, the aim this study is to assess the prevalence and associated factors of hemorrhoid among adult patients visiting the surgical outpatient department at the University of Gondar Comprehensive Specialized Hospital (UoGCSH) Northwest Ethiopia.MethodsAn institution-based cross-sectional study was conducted from February to May 2020. A systematic random sampling technique was used to select a total of 403 participants. The data were collected then entered using EPI DATA version 3.1 and exported to the STATA 14 for analysis. Bivariable and multivariable logistic regression analysis were performed. Adjusted odds ratio (AOR) with 95% confidence interval was used as a measure of association. Variables having P-value < 0.05 from the multivariable analysis were considered to have a significant association with the outcome.ResultOut of the 403 study participants, 13.1% (95%CI; 10.1, 16.8) had hemorrhoids. Constipation (AOR = 4.32, 95% CI; 2.20, 8.48) and BMI ≥25kg/m2 (AOR = 2.6, 95% CI; 1.08, 6.23) had a statistically significant association with hemorrhoid.ConclusionThe overall prevalence of hemorrhoid was high and its prevalence was higher in male subjects. Constipation and being overweight were found to increase the odds of having hemorrhoids. Screening for early identification and intervention of hemorrhoids, especially for risk groups is better to be practiced by health professionals.

Determinants of Hospital Length of Stay among Burn Patients Using Quantile Regression

Determinants of Hospital Length of Stay among Burn Patients Using Quantile Regression

Cross-sectional observational study of epidemiology of COVID-19 and clinical outcomes of hospitalised patients in North West London during March and April 2020

ObjectiveThe aim of this paper is to describe evolution, epidemiology and clinical outcomes of COVID-19 in subjects tested at or admitted to hospitals in North West London.DesignObservational cohort study.SettingLondon North...

Magnitude and Factors Contributing to Erectile Dysfunction among Diabetic Men Attending the Diabetic Clinic at Debre Tabor Comprehensive and Specialized, Hospital in North West, Ethiopia 2020, Institutional Based Cross-Sectional Study

Background: Erectile dysfunction, which is defined as difficult to attain and maintain an erectile function enough to permit sufficient sexual performance, is accepted to be a big problem especially among diabetic patients. Objective To assess the Magnitude and factors contributing to Erectile Dysfunction Among Diabetic men attending the diabetic clinic in Debre Tabor Comprehensive and Specialized hospital, North West Ethiopia. Methods: Hospital based cross-sectional study was conducted on 362 participants in Debre Tabor Comprehensive and Specialized Hospital from August - December 2020 using systematic random sampling technique. Data were analyzed with SPSS Version 23. Binary and multivariable logistic regressions were done to identify factors which were contributing to erectile dysfunction. P-value 10 years), type of diabetes (type II), physical exercise, drinking alcohol, BMI, blood glucose, and blood pressure were associated with erectile dysfunction at 5% level (p ≤ 0.05). Multiple logistic regression analysis revealed that duration of diabetes 10 years (AOR = 6.2, 95% CI: 2.78 - 13.85, p = 0.001), co-existing hypertension (AOR: 3.59, 95% CI: 1.58 - 8.19, p = 0.002), physically inactive (AOR = 2.87, 95% CI: 1.53 - 8.31, p = 0.003), unsafe level alcohol intake (AOR: 3.09; 95% CI 1.45 - 6.59*, p = 0.003) and raised blood glucose (AOR: 15.26, 95% CI: 7.82 - 29.77, p = 0.004) were independent risk factors but no association was found with other variables. Conclusion: The magnitude of erectile dysfunction in this study population was 59.7% and associated with the type of diabetes; duration of diabetic, physical exercise, alcohol drinking, increase in blood pressure, and elevated blood glucose level were independently correlated with erectile dysfunction.

Work-family conflict during the Covid-19 pandemic: teleworking of administrative and technical staff in healthcare. An Italian study.

Background:Remote working (more appropriately, mandatory work from home) during the Covid-19 healthcare emergency has increased significantly. Amidst many critical issues, work-family conflict (WFC) remains a central topic, due to the hardships in separating different life domains, the pervasiveness of technology, and decreased opportunities for recovery, all considering new, emerging job demands. Although many studies have involved healthcare workers, less attention has been paid to technical-administrative staff (TA); moreover, previous studies about the impact of remote working on WFC have provided mixed results.Objectives:The study aims at examining the relationships between WFC and cognitive demands, off-work hours technology assisted job demands (off-TAJD) and recovery, in the TA of a hospital in northwest Italy.Methods:A sample of 211 individuals (response rate of 58%), in line with the population, filled in an online self-report questionnaire in the second half of April 2020.Results:Multiple regression analysis showed a positive relationship between WFC and perceived ICT stress, off-TAJD and cognitive demands, and a negative relationship with recovery.Conclusions:The results confirm the role of cognitive demands, technology overload and invasiveness, as potential predictors of WFC. The results also indicate the mitigating role of recovery, even in the face of a prolonged and forced experience of remote work. The study emphasises the need for transparent policies, based on trust, autonomy and right to disconnect, and the centrality of training, especially for supervisors, on topics such as evaluation of results, proper recovery management and correct use of technology.

Pain Management Knowledge of Nurses Working in Northwest Amhara Referral Hospitals in Ethiopia During 2018

BackgroundPain is an unpleasant emotional and sensory experience that is associated with actual or potential tissue damage. Providing comfort and relief of pain of clients are the fundamental role of nurses in nursing practices. However, inadequate knowledge of appropriate pain management has been reported to be a major obstacle to implementing effective pain management by nurses.ObjectiveThe objective of this study was to assess knowledge of pain management techniques in nurses working in referral hospitals in northwest Ethiopia.MethodsAn institution-based, cross-sectional, interviewer-administered questionnaire study of the pain treatment knowledge of 411 nurses was conducted in 2018 in Northwest Referral Hospitals in Ethiopia. The sample size was allocated to each selected referral hospital. A systematic sampling technique was used to select study participants. The descriptive data were presented in frequency tables. Binary and multivariable logistic regression analyses were undertaken to identify associated factors to pain management knowledge of nurses. Variables with a P value < 0.05 were considered as a significant variable.ResultsOnly 40.6% of nurses were judged to have had adequate knowledge regarding pain management. Number of years of training (adjusted odds ratio = 2.19; 95% CI, 1.39–3.44), prior pain education (adjusted odds ratio = 2.34; 95% CI, 1.45–3.8), and professional rank (adjusted odds ratio = 3.09; 95% CI, 1.37–6.96) were associated factors for pain management knowledge of nurses.ConclusionsThe level of many nurses’ knowledge of pain management techniques were inadequate. Lack of pain training in their institution, lack of pain education in their academic curriculum, and professional rank were predictors of these nurses’ pain management knowledge. Providing pain management training and employing higher service rank nurses are likely to result in increased nurses’ knowledge of proper pain management techniques. (Curr Ther Res Clin Exp. 2021; 82:XXX–XXX)© 2021 Elsevier HS Journals, Inc.

Knowledge and Attitude Towards the Current Pandemic Corona Virus Disease and Associated Factors Among Pregnant Women Attending Antenatal Care in Debre Tabor General Hospital Northwest Ethiopia: An Institutional-Based Cross-Sectional Study.

PurposeThe current emerging respiratory disease known as the novel Coronavirus 2019 (COVID-19) is now an international concern and a pandemic with non-availability of treatment. Due to altered physiology, weakened mechanical and immunological features pregnant mothers constitute a particularly suspectable segment of population in any infection pandemic. The goal of this study was to assess level of knowledge and attitude towards COVID-19 and determinants among pregnant mothers attending antenatal care (ANC) in Debre Tabor General Hospital Northwest Ethiopia.Patient and MethodsAn institutional-based cross-sectional study was performed from June 05 to 26, 2020. A total of 403 pregnant mothers participated and were selected by systematic random sampling. Data were collected via face-to-face interviewer-administered questionnaire. Data were entered using Epi-Data version 4.2 and analyzed by SPSS version 23. Bivariable and multivariable logistic regression analysis was performed and p-value <0.05 at 95% CI was considered as statistically significant.ResultsOverall, 52.1% and 52.6% of participants had a good level of knowledge and positive attitude towardCOVID-19, respectively. Level of knowledge was significantly associated with participants’ age (15–24 years) (AOR: 4.58; 95% CI: 1.721–12.201), educational status (AOR:7.78; 95% CI: 2.31–15.65) occupation (AOR:2.26; 95% CI: 1.23–4.15), and condition of pregnancy (AOR:4.55; 95% CI: 1.84–11.25). Whereas age (25–34 years) (AOR:2.61; 95% CI: 1.23–5.55), participants husband completed secondary education (AOR=2.75, 95% CI: 1.13–6.70) and college and above (AOR:3.77; 95% CI: 1.1.62–8.76), wanted pregnancy (AOR:2.70; 95% CI: 1.22–5.97) and knowledge (AOR:1.65; 95% CI: 1.06–2.572) were the significant predictors for attitude.ConclusionFindings show that almost half of the participants had a good level of knowledge and positive attitude towards COVID-19. Age, educational status, occupational status, condition of current pregnancy was positively associated with women level of awareness of COVID-19. Additional research is needed to see the impact of COVID-19 on pregnancy and feto-maternal effect.

RETRACTED ARTICLE: Prevalence and associated factors of early initiation of breastfeeding among women delivered via Cesarean section in South Gondar zone hospitals Ethiopia, 2020

BackgroundEarly initiation of breastfeeding is putting the newborn to breast within one hour after birth. This study was aimed to assess prevalence of early initiation of breastfeeding and its associated factors among mothers who delivered by cesarean section in South Gondar Zone hospitals Northwest Ethiopia, 2020.MethodsAn institutional based cross-sectional study was employed in South Gondar Zone hospitals from June 12 to July 03, 2020. A total of 356 cesarean delivered mothers were included. Data were collected using interviewer administered questionnaire and entered in to Epi Data version 4.2 and then exported to SPSS version 23.0. Logistic regression statistical analyses were used to identify factors associated with the outcome variables.ResultsThe prevalence of early initiation of breastfeeding among mothers who delivered by cesarean section was 51.9%. Mothers who had intended pregnancy [AOR = 2.69, 95% CI (1.34–5.38)], had professional guidance [AOR = 2.68, 95% CI (1.18–6.10)], had breastfeeding experience [AOR = 2.25, 95% CI (1.35–3.75)], and had four and above antenatal care visits [AOR = 2.20, 95% CI (1.24–3.91)] were positively associated with early initiation of breastfeeding among mothers who delivered by cesarean section.ConclusionType of pregnancy, professional guidance, had four or more antenatal care and breastfeeding experience were significantly associated with early initiation of breast feeding among mothers who delivered by cesarean section. Community based breastfeeding education and counseling to pregnant mothers and encouraging all mothers to follow recommended ANC visit is should be recommended.

Technical Efficiency of Maternal Health Services Provision in Public Hospitals of Northwest Ethiopia: A Two-Stage Data Envelopment Analysis.

IntroductionEthiopian health expenditure as a share of total government expenditure increased from 7.6% in 2013/14 to 8.1% in 2016/17. But it remained low even for the low-income country average expected share of 8.7%. It signifies the efficient use of scarce resources in the health sector is still critical to achieving sustainable development goals. But little evidence is available about public hospitals’ technical efficiency in providing maternal health services. Therefore, the aim of this study was to assess the technical efficiency of maternal health services provision of public hospitals in Northwest Ethiopia.MethodsFacility-based cross-sectional study was conducted among twelve randomly selected public hospitals. Input data (salary expenditure, non-salary expenditure, and the number of beds) and maternal health services output data (antenatal care, skilled delivery, and postnatal care) for a 2011 Ethiopian fiscal year (July 2018 to June 2019) were collected and entered into Epi-Data 3.1. We used both primary and secondary data collection procedures to determine independent variables and the dependent variable, respectively. We also used a two-stage input-oriented data envelopment analysis with variable returns to scale assumption.ResultsThe study showed that hospitals included in this study wasted US$ 6833.50 for salary and US$ 3886.8 for non-salary expenditures. The study also revealed that the mean pure technical efficiency of public hospitals for maternal health service provision was 0.92±0.142, and their scale efficiency was 0.795±0.24. The hospital manager’s experience year, the educational level of the manager, and the hospital service year associated positively with the technical efficiency. However, the catchment population and distance of another health facility associated negatively with technical efficiency.ConclusionThe public hospitals’ pure technical efficiency in the provision of maternal health services in Northwest Ethiopia was high. More than half of the public hospitals were technically efficient. The wasted amount of expenditures could be used for satisfying the unmet health services need of the population. Therefore, it is better to monitor the health facilities for the wise use of the existing resources for their best performance.

Clinical pattern and predictors of stroke treatment outcome among hospitalised patients who had a stroke at Felege Hiwot comprehensive specialised hospital, northwest Ethiopia: a retrospective cross-sectional study

ObjectivesThis study aimed to assess the clinical pattern and predictors of stroke treatment outcomes among hospitalised patients in Felege Hiwot comprehensive specialised hospital (FHCSH) in northwest Ethiopia.DesignA retrospective cross-sectional study.SettingThe...

&lt;p&gt;Magnitude and Factors Associated with Preoperative Anxiety Among Pediatric Patients: Cross-Sectional Study&lt;/p&gt;

BackgroundAnesthesia and surgery are common sources of anxiety and stressful experiences in children. This unpleasant sensation depends on several factors. This study aimed to determine the magnitude of preoperative anxiety and associated factors in pediatrics patients at the University of Gondar Comprehensive Specialized Hospital North West Ethiopia 2020.MethodsAn institutional-based cross-sectional observational study was conducted from March to September 2020 at the University of Gondar Comprehensive Specialized Hospital. After obtaining ethical approval from the institutional review board. All consecutive ASA physical status I & II boys and girls with the age of 2–12 years scheduled for a variety of elective (general, urologic, ENT, ophthalmic and other surgical) operations were included. The level of anxiety was measured using the Modified Yale Preoperative Anxiety Scale short form (m-YPAS-SF) observational tool. Parental anxiety was assessed using Spielberger’s short version of state-trait anxiety. Binary logistic regression analysis was performed to identify the association between preoperative children’s anxiety and independent variables. The strength of the association was present by adjusted odds ratios.ResultsThe magnitude of preoperative anxiety in children in the operation room was 75.44% (95% confidence interval (CI): 68.36, 81.34). Age (AOR: 3.83; 95% CI: 1.58, 9.30), previous surgery and anesthesia (AOR: 6.73, 95% CI: 1.25, 36.19), outpatient surgery (AOR: 5.16, 95% CI: 1.32, 20.23) and parental anxiety (AOR: 3.26, 95% CI: 1.30, 20.23) were significantly associated with preoperative children anxiety.ConclusionThe magnitude of preoperative anxiety in pediatric patients was considerably high in our setup. Younger age, previous surgery and anesthesia, outpatient surgical setting, and parental anxiety were the independent risk factors for preoperative anxiety. Therefore, the operating staff should assess the child’s anxiety and should consider appropriate anxiety reduction methods during the preoperative visit of pediatric patients and their families.

Ocular tuberculosis: A case series from a London hospital

Background: Ocular TB is defined as an infection of Mycobacterium tuberculosis involving any part of the eye. Estimates of 1.4% of patients with pulmonary tuberculosis have ocular involvement and though rare, this presentation can have devastating consequences if not recognised. We present a case series of ocular TB diagnosed at London North West Healthcare trust which serves a multicultural community with the highest rates of TB infection in the UK. Methods and materials: Retrospective analysis of laboratory and medical records, radiology and microbiology results of patients with ocular TB identified from the London TB register from September 2012 to July 2019 from London North West Hospitals University NHS Trust. Results: 28 patients with ocular TB were identified: 23 uveitis (10 anterior uveitis, 6 posterior uveitis, 7 panuveitis), 1 maculopathy, 1 optic neuritis, 1 epislceritis, 1 orbital fibrovascular TB lesion and 1 retinal periphlebitis. All were presumptive diagnoses with only one having ocular microbiological samples obtained; which were negative. 54% of cases were female, average age at diagnosis 48 years (range 22 to 72). 89.3% were migrants; 29% African and 61% South Asian, particularly Indian (39%). Average time from symptoms presenting to treatment commencing was 186 days. Only 2 patients had evidence of TB at other sites; both extra-pulmonary (mediastinal and extra thoracic lymph nodes). 1 patient was HIV positive. Nine patients (32.6%) received steroids (3 eye drops and 6 systemic therapies). Nearly all patients had either a reactive Mantoux test (10) or Interferon Gamma Release Assay (17). Treatment duration was usually the standard 6 months (57%) followed by 9 months (19%), 12 months (19%) and 13 months (5%) with 2 patients lost to follow up. 19 patients (67.9%) were treated with ethambutol sparing regimens usually replacing with moxifloxacin. 1 patient had blindness as a long term sequaela of ocular TB. Conclusion: Our case series demonstrates that ocular tuberculosis frequently occurs in the absence of pulmonary tuberculosis and should be considered in all cases of uveitis in patients from endemic regions.